Tabagisme: un facteur de risque de diabète de type 2

Les fumeurs ont un poids corporel inférieur de 3 à 4 kg à celui des non-fumeurs, mais ils ont tendance à accumuler davantage de graisse au niveau abdominal. De par ce mécanisme, ainsi que par une toxicité directe du tabac sur les cellules du pancréas ou encore une augmentation de l'inflammation systémique, les fumeurs ont un risque accru de développer un diabète de type 2 comparativement aux non-fumeurs. À l'arrêt du tabac, la majorité des fumeurs prennent du poids et le risque de diabète est augmenté dans les premières années qui suivent l'arrêt. Les bénéfices de l'arrêt sur la mortalité ou les événements cardiovasculaires ne sont toutefois pas affectés par cette augmentation transitoire du risque métabolique.

Perception et communication du risque: du diabète à la maladie cardiovasculaire [Risk perception and communication: from diabetes to cardiovascular diseases].

Evidence-based medicine has enabled to approach disease in a more rational and scientific way. Clinical research has identified behaviours and risk factors that could cause disease often "silent" at the beginning, such as diabetes. Despite the clear impact of these evidences on public health, it seems that the individual risk perception level remains weak. To mention as well, the health professionals very often have a different views, which makes it difficult to communicate the risk with patients. In this article we describe the principles of risk perception, the diabetes related risk perception concerning cardiovascular complications, and suggest some practical strategies and tools which could improve risk communication in the everyday practice.

A randomized crossover study to compare efavirenz and etravirine treatment.

BACKGROUND: Efavirenz (EFV) causes neuropsychiatric side-effects and an unfavourable blood lipid profile. We investigated the effect of replacing EFV with etravirine (ETR) on patient preference, sleep, anxiety and lipid levels. METHOD: Study participants did not complain of side-effects, had tolerated EFV for at least 3 months, with less than 50 copies/ml HIV-RNA. After randomization, the ETR-first group started with ETR (400 mg daily) [DOSAGE ERROR CORRECTED] with EFV-placebo and the EFV-first group with EFV with ETR-placebo. After 6 weeks, both groups switched to the alternate regimen. Nucleoside reverse transcriptase inhibitors were continued without any change. The primary end point was patient preference for the first or the second regimen, assessed after 12 weeks. RESULTS: Fifty-eight patients were enrolled with a median CD4 cell count of 589 cells/μl and the duration of previous EFV therapy was 3.9 years. Fifty-five patients completed the study. When asked about treatment preference after 12 weeks, 16 preferred EFV and 22 preferred ETR, whereas 17 did not express a preference (P = NS). Patients who continued EFV during the first phase of the trial preferred EFV (15/21, 71%), whereas patients who started with ETR were more likely to prefer ETR (n = 16/17, 94%). This order effect was strongly significant (P < 0.0001). Quality of sleep, depression, anxiety and stress scores did not differ significantly between groups. Median plasma cholesterol levels decreased by 0.7 mmol (29 mg/100 ml) after replacing EFV with ETR (P < 0.002). CONCLUSION: After substitution of EFV by ETR, patients did not express a significant preference for ETR. There was no measurable effect on neuropsychiatric symptoms and sleep. Cholesterol decreased.

Características químicas de um cambissolo húmico afetadas por sistemas de preparo, com ênfase à matéria orgânica

A matéria orgânica é um dos atributos de solo mais sensível às transformações desencadeadas pelos sistemas de manejo. Neste estudo, foram avaliados os conteúdos de C e N na matéria orgânica total e na sua fração grosseira, bem como as características químicas de um Cambissolo Húmico submetido ao preparo convencional, preparo reduzido e plantio direto, durante nove anos, no município de Lages, SC. O plantio direto e o preparo reduzido promoveram incrementos de 8,5 e 6,3 t ha-1 de C e 808 e 593 kg ha-1 de N na camada de 0-20 cm do solo, respectivamente, em relação ao preparo convencional. Os incrementos relativos do conteúdo de C e N na matéria orgânica total foram de 12 e 17%, respectivamente, no preparo reduzido, e de 17 e 24%, respectivamente, no plantio direto. A fração grosseira da matéria orgânica (> 53 ∝m) foi mais sensível ao sistema de preparo de solo do que a matéria orgânica total. Na fração grosseira, os incrementos de C e N foram de 85 e 45%, respectivamente, no preparo reduzido, e de 275 e 230%, respectivamente, no plantio direto, demonstrando ser um atributo adequado para avaliar o efeito de sistemas de manejo a curto prazo. A CTC efetiva do solo foi relacionada com o pH e com os teores de carbono (CTC efetiva = -13,53 + 3,58 pH + 3,51% C, R² = 0,76), demonstrando ser a matéria orgânica um contribuinte importante para a CTC desse solo. No plantio direto, ocorreu pequena estratificação de Ca e grande estratificação de P e K em profundidade, em comparação ao preparo reduzido e convencional. O pH e o Al não foram afetados pelos sistemas de preparo de solo. Não foi observada limitação química ao desenvolvimento vegetal e à produção das culturas nos três preparos de solo.

Stereospecificity of the siderophore pyochelin outer membrane transporters in fluorescent pseudomonads.

Pyochelin (Pch) and enantio-pyochelin (EPch) are enantiomer siderophores that are produced by Pseudomonas aeruginosa and Pseudomonas fluorescens, respectively, under iron limitation. Pch promotes growth of P. aeruginosa when iron is scarce, and EPch carries out the same biological function in P. fluorescens. However, the two siderophores are unable to promote growth in the heterologous species, indicating that siderophore-mediated iron uptake is highly stereospecific. In the present work, using binding and iron uptake assays, we found that FptA, the Fe-Pch outer membrane transporter of P. aeruginosa, recognized (K(d) = 2.5 +/- 1.1 nm) and transported Fe-Pch but did not interact with Fe-EPch. Likewise, FetA, the Fe-EPch receptor of P. fluorescens, was specific for Fe-EPch (K(d) = 3.7 +/- 2.1 nm) but did not bind and transport Fe-Pch. Growth promotion experiments performed under iron-limiting conditions confirmed that FptA and FetA are highly specific for Pch and EPch, respectively. When fptA and fetA along with adjacent transport genes involved in siderophore uptake were swapped between the two bacterial species, P. aeruginosa became able to utilize Fe-EPch as an iron source, and P. fluorescens was able to grow with Fe-Pch. Docking experiments using the FptA structure and binding assays showed that the stereospecificity of Pch recognition by FptA was mostly due to the configuration of the siderophore chiral centers C4'' and C2'' and was only weakly dependent on the configuration of the C4' carbon atom. Together, these findings increase our understanding of the stereospecific interaction between Pch and its outer membrane receptor FptA.

Influence of tree species on the herbaceous understory and soil chemical characteristics in a silvopastoral system in semi-arid northeastern Brazil

Studies from some semi-arid regions of the world have shown the beneficial effect of trees in silvopastoral systems, by promoting the formation of resource islands and increasing the sustainability of the system. No data are available in this respect for tree species of common occurrence in semi-arid Northeastern Brazil. In the present study, conducted in the summer of 1996, three tree species (Zyziphus joazeiro, Spondias tuberosa and Prosopis juliflora: ) found within Cenchrus ciliaris pastures were selected to evaluate differences on herbaceous understory and soil chemical characteristics between samples taken under the tree canopy and in open grass areas. Transects extending from the tree trunk to open grass areas were established, and soil (0-15 cm) and herbaceous understory (standing live biomass in 1 m² plots) samples were taken at 0, 25, 50, 100, 150 and 200% of the average canopy radius (average radius was 6.6 ± 0.5, 4.5 ± 0.5, and 5.3 ± 0.8 m for Z. joazeiro, P. juliflora, and S. tuberosa , respectively). Higher levels of soil C, N, P, Ca, Mg, K, and Na were found under the canopies of Z. joazeiro and P. juliflora: trees, as compared to open grass areas. Only soil Mg organic P were higher under the canopies of S. tuberosa trees, as compared to open grass areas. Herbaceous understory biomass was significantly lower under the canopy of S. tuberosa and P. juliflora trees (107 and 96 g m-2, respectively) relatively to open grass areas (145 and 194 g m-2). No herbaceous biomass differences were found between Z. joazeiro canopies and open grass areas (107 and 87 g m-2, respectively). Among the three tree species studied, Z. joazeiro was the one that presented the greatest potential for use in a silvopastoral system at the study site, since it had a larger nutrient stock in the soil without negatively affecting herbaceous understory biomass, relatively to open grass areas.

Crescimento e acúmulo de nutrientes por plantas espontâneas e por leguminosas utilizadas para adubação verde

As espécies vegetais espontâneas, nas áreas de cultivo agrícola, têm sido tratadas como "plantas daninhas", "ervas invasoras", "inços" e outras denominações, do ponto de vista dos prejuízos que podem acarretar às espécies cultivadas. No entanto, as espontâneas podem promover os mesmos efeitos de proteção do solo e ciclagem de nutrientes que espécies cultivadas ou introduzidas para adubação verde. O crescimento e o acúmulo de nutrientes pela parte aérea de espontâneas e de leguminosas utilizadas como adubos verdes foram medidos em um experimento de campo em Sete Lagoas (MG), na Embrapa Milho e Sorgo. O experimento consistiu de cinco espécies de leguminosas (feijão-de-porco, feijão-bravo do Ceará, mucuna-preta, lab-lab e guandu), submetidas a duas condições de manejo (com e sem capina), e uma testemunha (somente espontâneas). No florescimento das leguminosas, foram obtidos a massa da matéria seca e o teor de nutrientes da parte aérea de cada espécie de leguminosa e das espontâneas presentes nas parcelas. O sistema com apenas as espontâneas produziu menos biomassa e acumulou menos nutrientes que os sistemas com leguminosas. Foram poucas as espontâneas que apresentaram teores de carbono, cálcio e nitrogênio próximos ou superiores aos das leguminosas. No entanto, para potássio, magnésio e fósforo, ocorreu o inverso. A maioria das espontâneas apresentou teores de potássio, magnésio e de fósforo superiores aos das leguminosas, destacando-se: Portulaca oleracea, Euphorbia heterophylla, Bidens pilosa, Commelina benghalensis e Melanpodium perfoliatum.

Autosomal-dominant distal myopathy associated with a recurrent missense mutation in the gene encoding the nuclear matrix protein, matrin 3.

Distal myopathies represent a heterogeneous group of inherited skeletal muscle disorders. One type of adult-onset, progressive autosomal-dominant distal myopathy, frequently associated with dysphagia and dysphonia (vocal cord and pharyngeal weakness with distal myopathy [VCPDM]), has been mapped to chromosome 5q31 in a North American pedigree. Here, we report the identification of a second large VCPDM family of Bulgarian descent and fine mapping of the critical interval. Sequencing of positional candidate genes revealed precisely the same nonconservative S85C missense mutation affecting an interspecies conserved residue in the MATR3 gene in both families. MATR3 is expressed in skeletal muscle and encodes matrin 3, a component of the nuclear matrix, which is a proteinaceous network that extends throughout the nucleus. Different disease related haplotype signatures in the two families provided evidence that two independent mutational events at the same position in MATR3 cause VCPDM. Our data establish proof of principle that the nuclear matrix is crucial for normal skeletal muscle structure and function and put VCPDM on the growing list of monogenic disorders associated with the nuclear proteome.

Integration of genome-wide association studies with biological knowledge identifies six novel genes related to kidney function.

In conducting genome-wide association studies (GWAS), analytical approaches leveraging biological information may further understanding of the pathophysiology of clinical traits. To discover novel associations with estimated glomerular filtration rate (eGFR), a measure of kidney function, we developed a strategy for integrating prior biological knowledge into the existing GWAS data for eGFR from the CKDGen Consortium. Our strategy focuses on single nucleotide polymorphism (SNPs) in genes that are connected by functional evidence, determined by literature mining and gene ontology (GO) hierarchies, to genes near previously validated eGFR associations. It then requires association thresholds consistent with multiple testing, and finally evaluates novel candidates by independent replication. Among the samples of European ancestry, we identified a genome-wide significant SNP in FBXL20 (P = 5.6 × 10(-9)) in meta-analysis of all available data, and additional SNPs at the INHBC, LRP2, PLEKHA1, SLC3A2 and SLC7A6 genes meeting multiple-testing corrected significance for replication and overall P-values of 4.5 × 10(-4)-2.2 × 10(-7). Neither the novel PLEKHA1 nor FBXL20 associations, both further supported by association with eGFR among African Americans and with transcript abundance, would have been implicated by eGFR candidate gene approaches. LRP2, encoding the megalin receptor, was identified through connection with the previously known eGFR gene DAB2 and extends understanding of the megalin system in kidney function. These findings highlight integration of existing genome-wide association data with independent biological knowledge to uncover novel candidate eGFR associations, including candidates lacking known connections to kidney-specific pathways. The strategy may also be applicable to other clinical phenotypes, although more testing will be needed to assess its potential for discovery in general.

Alteração de atributos químicos no perfil do solo pela calagem superficial em campo nativo

Grande parte das áreas ocupadas por pastagens no estado do Rio Grande do Sul apresentam solos ácidos que, se convenientemente corrigidos, podem ser incorporados na produção de grãos. O objetivo desta pesquisa foi avaliar a alteração de atributos químicos no perfil de um solo ácido de campo natural após receber a aplicação de calcário e ser cultivado sob diferentes manejos. Dois experimentos foram realizados: um no campo e outro em colunas de solo, em laboratório. O experimento de campo foi instalado em 1993 em área de pastagem natural nunca antes cultivada, em Latossolo Vermelho distrófico típico, no município de Cruz Alta (RS). Foram aplicadas quatro doses de calcário dolomítico (0, 2, 4 e 6 t ha-1), sem incorporação ao solo (sistema plantio direto) e com incorporação (cultivo convencional). Após 42 meses de cultivo contínuo com espécies anuais (verão e inverno), amostras de solo foram coletadas em diferentes camadas no perfil do solo na área experimental e em área adjacente de campo nativo. Nesta ocasião, foram, também, coletadas colunas de PVC com amostras indeformadas de solo nas parcelas testemunhas (sem aplicação de calcário) de ambos os tratamentos de manejo de solo e na área de campo nativo, adjacente. Nelas, foram aplicadas, na superfície do solo, duas doses de calcário (0 e 6 t ha-1) e submetidas a uma chuva simulada de 32,5 mm por semana durante 25 semanas. O solo de ambos os experimentos foi analisado em diversas camadas. Enquanto os valores dos atributos químicos foram uniformes na camada de solo mobilizada para a incorporação do calcário no cultivo convencional, houve alteração em profundidade quando o calcário foi distribuído na superfície e cultivado no sistema plantio direto. A magnitude e a profundidade das camadas afetadas foram proporcionais às doses de calcário aplicadas. As alterações ocorreram em maior profundidade no campo nativo do que nos sistemas plantio direto e convencional pela aplicação superficial de calcário em colunas indeformadas de solo e submetidas à chuva simulada. A utilização do campo nativo para o cultivo de espécies anuais por 42 meses alterou substancialmente os atributos químicos originais, independentemente do manejo.

Dépendances [Addictions]

This year reviews on the addictions emphasizes five aspects, on a bio-psycho-social perspective: (1) The relationship between methadone and cardiotoxicity. (2) The introduction of Eye Movement Desensibilization and Reprocessing (EMDR). (3) The apparition of a possible specific pharmacotherapy for excessive gambling. (4) A better knowledge of the relationship between cannabis and psychoses. (5) Resistance to treatment in the doctor-patient relationship.

Gramíneas e leguminosas na recuperação de áreas degradadas: efeito nas características químicas de solo

Com o objetivo de avaliar a eficiência de duas leguminosas e duas gramíneas na melhoria das características químicas do solo (carbono orgânico, CTC efetiva e potencial e teores de P, K, Na, Ca, Mg, H + Al e pH do solo), considerando a profundidade e a posição de coleta das amostras, foi realizado experimento com arranjo fatorial em parcelas subdivididas, utilizadas anteriormente para estudos de perdas de solos por erosão, em um Nitossolo Vermelho eutrófico textura argilosa, localizado no município de Alagoinha (PB). Os tratamentos utilizados constituíram-se de duas leguminosas (feijão guandu - Cajanus cajan L. e siratro - Macroptilium atropurpureum L.), duas gramíneas (capim-pangola - Digitaria decumbens L. e capim-elefante - Pennisetum purpureum L.) e parcela desnuda (testemunha), com três repetições. A utilização das leguminosas e das gramíneas promoveu aumentos nos teores de carbono orgânico total e na capacidade de troca de cátions; promoveu, também, aumento nos teores de potássio, matéria orgânica e magnésio, principalmente na camada superficial. O maior acúmulo de liteira foi conseguido com o capim-elefante, sendo este acúmulo maior na posição inferior das parcelas em todos os tratamentos.

Chemical changes in argisols under irrigated grape production in the central São Francisco river valley, Brazil

This study compares the chemical composition of the solution and exchange complex of soil in a 3-year-old irrigated vineyard (Vitis vinifera L., Red Globe cultivar) with that of adjacent clearing in the native hyperxerophyllic 'caatinga' vegetation. The soils are classified as Plinthic Eutrophic Red-Yellow Argisol; according to Soil Taxonomy they are isohyperthermic Plinthustalfs. Detailed physiographic characterization revealed an impermeable gravel and cobble covering the crystalline rocks; the relief of this layer was more undulating than the level surface. Significant higher concentrations of extractable Na, K, Mg and Ca were observed within the vineyard. Lower soil acidity, higher Ca/Mg ratios, as well as lower sodium adsorption and Na/K ratios reflected additions of dolomitic lime, superphosphate and K-bearing fertilizers. As the water of the São Francisco River is of good quality for irrigation (C1S1), the increases in Na were primarily attributed to capillary rise from the saline groundwater table. None of the soil in the study area was found to be sodic. About 62% of the vineyard had an Ap horizon with salinity levels above 1.5dSm-1 (considered detrimental for grape production); according to average values for this horizon, a potential 13% reduction in grape production was predicted. Differences in chemical composition in function of distance to the collector canals were observed in the clearing, but not in the vineyard. The influence of differences in the elevations of the surface and impermeable layers, as well as pediment thickness, was generally weaker under irrigation. Under irrigation, soil moisture was greater in points of convergent surface waterflow; the effect of surface curvature on chemical properties, though less consistent, was also stronger in the vineyard.

Endothelin-1-induced spreading depression in rats is associated with a microarea of selective neuronal necrosis.

Two different theories of migraine aura exist: In the vascular theory of Wolff, intracerebral vasoconstriction causes migraine aura via energy deficiency, whereas in the neuronal theory of Leão and Morison, spreading depression (SD) initiates the aura. Recently, it has been shown that the cerebrovascular constrictor endothelin-1 (ET-1) elicits SD when applied to the cortical surface, a finding that could provide a bridge between the vascular and the neuronal theories of migraine aura. Several arguments support the notion that ET-1-induced SD results from local vasoconstriction, but definite proof is missing. If ET-1 induces SD via vasoconstriction/ischemia, then neuronal damage is likely to occur, contrasting with the fact that SD in the otherwise normal cortex is not associated with any lesion. To test this hypothesis, we have performed a comprehensive histologic study of the effects of ET-1 when applied topically to the cerebral cortex of halothane-anesthetized rats. Our assessment included histologic stainings and immunohistochemistry for glial fibrillary acidic protein, heat shock protein 70, and transferase dUTP nick-end labeling assay. During ET-1 application, we recorded (i) subarachnoid direct current (DC) electroencephalogram, (ii) local cerebral blood flow by laser-Doppler flowmetry, and (iii) changes of oxyhemoglobin and deoxyhemoglobin by spectroscopy. At an ET-1 concentration of 1 muM, at which only 6 of 12 animals generated SD, a microarea with selective neuronal death was found only in those animals demonstrating SD. In another five selected animals, which had not shown SD in response to ET-1, SD was triggered at a second cranial window by KCl and propagated from there to the window exposed to ET-1. This treatment also resulted in a microarea of neuronal damage. In contrast, SD invading from outside did not induce neuronal damage in the absence of ET-1 (n = 4) or in the presence of ET-1 if ET-1 was coapplied with BQ-123, an ET(A) receptor antagonist (n = 4). In conclusion, SD in presence of ET-1 induced a microarea of selective neuronal necrosis no matter where the SD originated. This effect of ET-1 appears to be mediated by the ET(A) receptor.